NPIMap

Organization Active NPI

Florida Department of Health

Doing business as Taylor County Health Department

  • Public Health or Welfare Agency
  • Perry, FL
National Provider Identifier
1376511915
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Doing business as
Taylor County Health Department
Practice address
1215 N Peacock Ave
Perry, FL 32347-2117
Phone
(850) 584-5087
Fax
(850) 584-8653
NPI assigned
Mar 9, 2006
Last updated
Aug 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stephen C. Tullos
Title
Administrator
Phone
(850) 584-5087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1215 N Peacock Ave
Perry, FL 32347-2117

Mailing address

1215 N Peacock Ave
Perry, FL 32347-2117
Phone (850) 584-5087

Other identifiers 4

IdentifierTypeStateIssuer
027972291MedicaidFL
027972201MedicaidFL
027972207MedicaidFL
027972230MedicaidFL

Other names 1

  • Taylor County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000034 FL Part B Supplier - Clinic/Group Practice 3072424282 Receives reassigned benefits from 5 practitioners
Practice locations: Perry, FL

National Provider Directory

National Provider Directory
Tax ID family
Agape Community Health185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1215 N Peacock Ave
Perry, FL 32347
Phone (850) 584-5087

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walton Community Health CenterDefuniak Springs, FL, CCN 101136 Federally qualified health center Operational/Managerial Control (100%) Sep 7, 2010
Bradford Community Health Care IncStarke, FL, CCN 101182 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2013

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1376511915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N PEACOCK AVE",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472117",
            "telephone_number": "850-584-5087",
            "fax_number": "850-584-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N PEACOCK AVE",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472117",
            "telephone_number": "850-584-5087",
            "fax_number": "850-584-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "TULLOS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-584-5087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027972291",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027972201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027972207",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027972230",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perry, FL

Sources for this page

Verify at the official NPI Registry.